2023-06-30 02:00:50
ISSSTE specialists removed a brain tumor that was larger than an egg.
For greater safety and precision, the neurosurgeons decided to operate with the awake patient technique.
Professionals in radiology oncology, neuropsychology, anesthesiology, neurology, and nurses participated in the complex procedure.
Thanks to the teamwork of the staff of the Institute of Security and Social Services of State Workers (ISSSTE) managed to remove the brain tumor from a patient. The story itself is already satisfactory but there is also another element that makes it even more surprising.
Description of the clinical case
The beneficiary’s name is Héctor Silva and he is 50 years old. What has most caught the attention of his case is that he was awake and singing “Las Mananitas” in the operating room while specialists from the National Medical Center “November 20” They removed a brain tumor larger than an egg, which was a metastasis of kidney cancer.
The neurosurgery was carried out on May 11, in optimal safety conditions for the patient because state-of-the-art technologies were applied. A multidisciplinary team of specialists led by the Neurosurgeon Cuauhtémoc Gil Mejía and made up of professionals in radiology oncology, neuropsychology, anesthesiology, neurology, and nurses participated in the complex procedure.
Héctor Silva remembers that in April of this year he went to the hospital for a check-up and when he left to start his return home he felt confused. I told the doctor: “I have a problem, they lowered my switch. I don’t remember anything,” I told him. “If you ask me my name, I don’t know who I am. Can you help me?”
With such a state of confusion, the diagnosis of this patient’s brain tumor began, said neurosurgeon Gil Mejía. It became a tractographya state-of-the-art, tumor-specific MRI study that helped plan the surgical procedure by identifying all areas of the brain compromised by the tumor, which may involve movement, sensation, language, or function of the memory.
We present the case of the patient Héctor Silva to whom specialists from the @cmn20noviembre They removed a brain tumor.
???? https://t.co/r5KGH5j0AG#HealthForAll pic.twitter.com/xbheR3PtjB— ISSSTE (@ISSSTE_mx) June 29, 2023
A rather large tumor was identified, measuring four and a half to five centimeters in length by three and a half in thickness, approximately. It was located on the left side of the brain, which explained the mental confusion that the patient presented.
“For greater safety and precision in tumor removal, we decided to operate with the awake patient technique.”
During neurosurgery, trans-surgical ultrasound was used to help visualize in real time and in vivo the size and dimensions of the tumor and its vascularity.
Neurosurgery with the patient awake
The neuropsychologist was in charge of evaluating the mental state of the patient. Keep him awake, talking and alert, asking him questions, showing him illustrations so he can identify figures, and making sure that his brain functions are not altered.
Prior to resection of the lesion, the language, motor areas of the hand and leg were stimulated with a device called a low-voltage cortical stimulator.
“This is important because it is a mapping to identify eloquent areas of the brain, they are fundamental and critical areas to prevent the patient from leaving with any injury.”
Once these areas were identified, the tumor was resected and removed safely.
Four days after surgery, the patient responded favorably to the functional neurological evaluation, and was ready to go home on his own, with a very good result and preservation of his brain functions. Currently, he is recovering satisfactorily and continues under medical surveillance from an outpatient clinic.
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